Holland 2005.

Study characteristics
Methods	RT Setting: home visit study (primary care) Study duration: 6 months
Participants	872 participants in a home visit study. Researchers recruited patients from four general hospitals and six community hospitals if they were aged ≥ 80 years, admitted as an emergency, intended to be discharged to their own home or warden‐controlled accommodation, and prescribed ≥ 2 drugs on discharge. Exclusion criteria: participants received dialysis treatment and participation in an intensive discharge service on 1 site Age (years) (mean ± SD): intervention 85.4 (4); control 85.5 (4); not significant Sex female n (%): intervention 262 (61.1); control 272 (63.8); not tested for significance Country: UK Comorbidity: baseline diagnosis: cardiovascular (total): intervention 134 (31.2), control 144 (33.8); myocardial infarction/angina: intervention 57 (13.3), control 65 (15.3); heart failure: intervention 38 (8.9), control 34 (8.0); musculoskeletal (total): intervention 61 (14.2), control 65 (15.3); fracture: intervention 37 (8.6), control 40 (9.4); gastrointestinal (total): intervention 47 (11.0), control 54 (12.7); respiratory (total): intervention 48 (11.2), control 49 (11.5); COPD/asthma: intervention 15 (3.5), control 13 (3.1); lower respiratory tract infection: intervention 16 (3.7), control 22 (5.2); neurological: intervention 40 (9.3), control 25 (5.9); stroke/transient ischaemic attack: intervention 16 (3.7), control 14 (3.3); senility/dementia: intervention 16 (3.7), control 6 (1.4); genitourinary: intervention 17 (4.0), control 16 (3.8); cancer (total): intervention 15 (3.5), control 7 (1.6); other or unclassified: intervention 67 (15.6), Control 66 (15.5) Sociodemographic: not mentioned Ethnicity: not mentioned Participants recruited between October 2000 and December 2002
Interventions	Initial referral to a review pharmacist included a copy of the participant's discharge letter. Pharmacists arranged home visits at times when they could meet participants and carers. Pharmacists assessed participants' ability to self‐medicate and drug adherence, and they completed a standardised visit form. Where appropriate, they educated the participant and carer, removed out of date drugs, reported possible drug reactions or interactions to the general practitioner, and reported the need for a compliance aid to the local pharmacist. Where a compliance aid was recommended, this was provided within the trial and a filling fee was paid to the local pharmacist. 1 follow‐up visit occurred at 6‐8 weeks after recruitment to reinforce the original advice. Control participants received usual care.
Outcomes	The primary outcome was total number of emergency admissions to hospital over 6 months. Secondary outcomes included deaths, admissions to residential homes and nursing homes, and self‐assessed QoL measured using the EQ‐5D. Participants also rated their health on a visual analogue scale from 100 (perfect health) to 0 (worst imaginable health). The EQ‐5D and visual analogue scales were collected at baseline, 3 months, and 6 months. Data were collected on emergency admissions from hospital episode statistics.
Notes
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Third party telephone randomisation based on a computer‐generated sequence in blocks of varying length. Randomisation appeared adequate
Allocation concealment (selection bias)	Low risk	Sequence was concealed based on what is noted above about sequence generation
Blinding of participants and personnel (performance bias) All outcomes	High risk	This was not done as stated in the manuscript, "Because of the nature of the intervention, no “placebo” could be provided. Participants were told after randomisation which group they were in."
Incomplete outcome data (attrition bias) All outcomes	Low risk	Follow‐up of the main outcome (hospital admissions) was good—only 3% of participants withdrew or were lost to follow‐up.
Blinding of outcome assessment (detection bias) All outcomes	Low risk	This is less important for our purpose as we are looking at objective outcomes (hospitalisations, ED visits, and mortality).
Selective reporting (reporting bias)	Low risk	No evidence of selective reporting
Protection against contamination bias	Unclear risk	It can not be determined if the control group has been contaminated by intervention
Other bias	Low risk	There is no other bias.